Question
I am a 30 year old male serving in the U.S. Army.  I initially had heel pain approximately one year ago in my left foot.  After many visits to the Doc, visits to Physical Therapy, etc. they decided I had plantar fasciitis.  I have gone through several sets of orthotics in an attempt to treat the condition.  When I deployed to Afghanistan, my right foot began bothering me.  I went to the Doc and was told that it might not be plantar fasciitis, but fat pad atrophy.  Obviously, they can't do anything about it in Afghanistan.  When I return to my duty station, how can I find out exactly what the problem is so that I can get it fixed?  Is this something that an MRI would show?  Thank you for your time!

Answer
This Chicago & Elmhurst Podiatrist says........

First of all--THANK-YOU FOR DEFENDING OUR COUNTRY!!!!!

If it hurts first thing in the morning or after rest-it's plantar fasciitis. If that's the case then try a night splint-but only wear about an hour before you get up from bed and put on if you know when you sit for a while and it is going to hurt. If you wear it all night-it will drive you crazy.Check out our website store at AnkleNFoot.com for examples.
The only way a 30 y/o can get fat pad atrophy is with a few cortisone injections.If you are overweight-that will make treatment a little more difficult.
Try stretching your calves with your knees locked. Tight calves are the primary mechanical cause of plantar fasciitis. Also try stretching your arch by crossing the affected leg over the other while seated and pull up on the toes and foot until you feel a stretch in the area of pain. Google for plantar fasciitis exercises. The two that I mentioned seem to work the bast for my patients. Try adding a soft heel pad to the top of the orthotics-which will decrease the force of tight calves and act as a heel lift. Orthotics usually work AFTER the fasciitis quiets down.
Max dose of Alleve for 5-7 days-if you can tolerate will help. Icing may help. Wrapping the arch will help.Restart the therapy and ask them to use ultrasound on the plantar fascia and do calf and arch stretches.
When you get back-try to find a Board Certified Podiatrist in Orthopedics- they can make the diagnosis with an x-ray and a good hands on exam. The MRI-if needed- should also be ordered by the Podiatrist. Army Docs are GREAT at saving lives-not making subtle diagnoses that involve body mechanics.


Hope this helps!
Good Luck My Friend!

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661
AnkleNFoot.com
Runnersdoc.com
BabyFootDoc.com

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